NYAPRS Note: Yesterday’s Capitol news conference by New Yorkers with psychiatric disabilities delivered strong support for Governor Cuomo’s reconfiguration of the state operated mental health system... if the state reinvests savings from that plan to properly bolster local nonprofit community services and gives consumer input priority over what services should be prioritized.

ALBANY - Groups representing mental health patients backed the Cuomo administration’s plan to reduce the number of New York psychiatric hospitals but called on the state Tuesday to “reinvest” the money it saves into localized care for the mentally ill.

A coalition of organizations held a news conference in Albany to promote the state Office of Mental Health’s plan, which would close hospitals in Binghamton and Elmira en route to consolidating 24 inpatient facilities into 15 regional centers by 2017. The Rochester Psychiatric Center, for example, would become a regional forensic care facility focusing on court-ordered patients.

But the advocates said the state should take the money it expects to save - an estimated $20 million in the first year of the three-year plan - and put it back into patient care.

Glenn Liebman, CEO of the Mental Health Association in New York State, said he wants to see the state commit to ensuring “any bed, ward or facility closure, or any attrition of the workforce is reinvested into community services.” He warned against directing the cost savings into the state’s general fund.

“Today, we’re not talking about jobs or hospitals or payment methodology,” Liebman said Tuesday. “We’re talking about recovery.”

The plan backed by Gov. Andrew Cuomo’s administration, which was unveiled last week, puts a greater emphasis on “community services” by boosting care at 26 outpatient “hubs” across the state. The state spends about $6.6 billion annually on mental-health care, including federal dollars.

But the hospital closures have met with significant criticism from the state’s largest public union and some local lawmakers, including Senate Deputy Republican Leader Thomas Libous, R-Binghamton, who has pledged to fight the closures. The plan allows the state Office of Mental Health to begin closing the hospitals in 2014.

“It’s disappointing that members of the mental health services community would be so quick to embrace the vague and superficial outline put forth by the Cuomo administration,” Danny Donohue, president of the state Civil Service Employees Association, said in a statement. “New York has never followed through with promised reinvestment for adequate mental health services over the past generation.”

Ben Rosen, a spokesman for the Office of Mental Health, said regional panels would identify areas that need an expansion of community-based care as the plan moves forward. Any “reinvestment of savings will be based upon the needs of respective communities,” he said.

“The Office of Mental Health is committed to the expansion of community-based mental health services in New York state,” Rosen said.

ALBANY - Advocates for the mentally ill said Tuesday they are endorsing Gov. Andrew Cuomo’s plan to close 24 state psychiatric hospitals and open 15 new regional treatment centers.

Glenn Liebman, CEO of the Mental Health Association in New York, said 20 percent of the money spent on mental health care is going toward 1 percent of the patients in state hospitals.

“If you move that 20 percent more into the community, you would see a lot more services and a lot more opportunities for people to recover and move forward in their lives as the folks here have.”

Among other things, the plan calls for closing psychiatric hospitals in the southern and northern tiers of the state and moving patients to new centers in Rochester and Syracuse.

Briana Gilmore of the New York Association of Psychiatric Rehabilitation Services said Cuomo’s plan will protect the state jobs and the services needed by the most vulnerable mentally ill.

“We know that state hospitals make their own employment decisions, and while the jobs of state employees are very important and need to be protected, we do know without a proper plan in place these jobs can be lost without adequate training and timely reinvestment in a proper manner,” she said.

Public employee unions fault Cuomo’s plan for being deliberately vague and a transparent effort to shed jobs and services. CSEA dismissed the advocates’ Tuesday press conference as a “pep rally” for Cuomo.

“It’s disappointing that members of the mental health services community would be so quick to embrace the vague and superficial outline put forth by the Cuomo administration,” CSEA President Danny Donohue said. “New York has never followed through with promised reinvestment for adequate mental health services over the past generation. Instead, too many individuals and families have been left without the help they need and local officials and taxpayers have had to deal with the human wreckage at their own expense. There is no evidence in the state’s latest sketchy proposal that promised changes will meet the needs of real people and communities.”

Critics of the state’s mental health system say county jails and prisons have turned into de facto mental institutions because of the number of incarcerated people who are mentally ill. Liebman said hospital beds will still be there for those who need them.

He said the Fourth of July weekend arrest of a mentally ill man for killing his mother and stepfather in Rensselaer County should not be viewed as a failure of public health care programs.

“As part of this proposal, what we’re trying to see happen is a full community reinvestment because if we get those kinds of services in the community, you are going to see a lot less trans-institutionalization where people are going right from the hospitals into prisons and jails,” Liebman said.

The state Office of Mental Health and Gov. Andrew Cuomo's administration want to restructure mental health care in New York.

They're promising the moon and the sun, a brand-new day with "centers of excellence" in forensic mental health and a new focus on enhanced community services.

The problem is that these are the same promises we've heard for the past 40 years. Somehow, those promises always seem to get broken as soon as someone decides that the savings gleaned from cuts in mental-health spending can be used to feather the nest of some other interest group with a whole lot more lobbying power and appeal than people with mental illness.

We get another round of cuts to services and hospital closures and job losses, without adding community services to pick up the slack.

The OMH/Cuomo plan to close some psychiatric hospitals and replace them with regional centers supplemented by community-based treatment has drawn praise from patient advocacy groups. But its praise (was) tempered with the warning that those community outpatient services are absolutely necessary.

The plan is to consolidate 24 state psychiatric hospitals into 15 regional centers with 24 affiliated outpatient hubs in communities with a history of high usage, while preserving jobs. The savings from the closings/consolidations would be reinvested in community-based services.

Those are "several steps in the right direction," according to representatives from the Mental Health Association in New York State and the New York State Association of Psychiatric Rehabilitation Services.

Community-based care is a good thing, and it's where most people who use the public mental-health system go. According to the state, about 715,000 New Yorkers used the mental-health care system in 2012; of those, 10,000 got care in inpatient hospitals. The state spends roughly $1.3 billion per year on those 10,000 inpatients compared with $5.3 billion on the other 705,000.

Again, the advocates are behind "realignment," but they want the people who actually need and use those resources to have a say in how the system is retooled.

The U.S. Supreme Court ruled that people with mental illness must be treated in the least-restrictive environment possible. Locking people away, absent some clear and compelling reason, is inhumane and counterproductive.

"Closing state psychiatric hospitals is only half of the equation," said Briana Gilmore of NYAPRS. "Without adequate reinvestment into recovery-oriented, rehabilitative services, people will not be given the opportunity to recover fully in the community."

The new state plan promises accountability in care; access to affordable housing, education and jobs; early detection of illness and community treatment.